- A Cochrane review finds that the benefits of antibiotics for induction or maintenance of remission of Crohn's disease (CD) are modest and may not be clinically meaningful.
- Antibiotics are not harmful, although the risk for serious adverse events remains uncertain.
Why this matters
- Firm conclusions cannot be drawn about the efficacy and safety of antibiotics on the induction and maintenance of remission.
- Review and pooled analysis of 13 randomized controlled trials after a review of MEDLINE, EMBASE, CENTRAL, the Cochrane IBD Group Specialized Register, and clinicaltrials.gov.
- Funding: None disclosed.
- In pooled analysis, 14% fewer antibiotic than placebo recipients failed to enter clinical remission at 6-10 weeks (risk ratio [RR], 0.86; 95% CI, 0.76-0.98).
- No fewer antibiotic than placebo recipients failed to maintain clinical remission at 52 weeks' follow-up (RR, 0.87; 95% CI, 0.52-1.47).
- 23% fewer antibiotic than placebo recipients failed to achieve clinical response at 10-14 weeks (RR, 0.77; 95% CI, 0.64-0.93).
- Antibiotic recipients (vs placebo) had no greater likelihood of adverse events as a whole, but likelihood of serious adverse events was uncertain.
- Heterogeneity across studies.
- Evidence quality ranges from high to low, depending on the outcome.